Clinical Trial: Phase III Study in Refractory Behcet's Disease

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: A 24 Week Multicenter, Randomized, Double-masked, Placebo Controlled Study to Assess the Difference in the Rate of Recurrent Exacerbations in Behçet¿s Patients With Posterior or

Brief Summary: The purpose of this pivotal trial is to evaluate subcutaneous (SQ) AIN457 as an adjunctive therapy to reduce the rate of exacerbations of posterior uveitis or panuveitis secondary to Behçet's disease during the 24 weeks of study therapy as compared to standard of care alone.

Detailed Summary:
Sponsor: Novartis Pharmaceuticals

Current Primary Outcome:

• Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment [ Time Frame: Baseline to week 24 ]
• Rate of Recurrent Ocular Exacerbations in the Study Eye During 24 Weeks by Treatment [ Time Frame: 24 weeks ]
  Patients number of occurences during a 24 week period.

Original Primary Outcome: To determine if AIN457 is effective in reducing the rate of posterior segment uveitis exacerbations secondary to Behçet's disease, as assessed by visual acuity, anterior chamber cells and vitreous haze. [ Time Frame: Wk 1-8; wk 12; wk 16; wk 22, and wk 24 ]

Current Secondary Outcome:

• Change From Baseline for Composite Immunosuppressive Medication Score at Week 24 by Treatment (Full Analysis Set) [ Time Frame: 24 weeks ]
  For each corticosteroid medication, dose of the corticosteroid was first converted to a prednisone-equivalent dose. To determine the prednisone equivalent dose, the corticosteroid dose was multiplied by a conversion factor. . The total prednisone equivalent dose was calculated as the sum of the prednisone equivalent doses of all corticosteroids. Consequently, the total converted prednisone equivalent dose was used to obtain the immunosuppressive score. The key secondary efficacy variable was the change in total post-baseline immunosuppressive medication score from baseline.The score is actually the prednisoone equivalents taken by patient as calculated by conversion table. A reduction in prenisone or prenisone equivalents is a positive outcome. An increase in the number of prednisone equivalents suggests that the treatment is not efficacious or that there is disease progression. A score of 0 would be the lowest ( no steriods taken) and the upper limit is indeterminate.
• To Determine the Effect of AIN457 on Macular Edema and Visual Acuity in Patients With Posterior Segment Uveitis Secondary to Behçet's Disease as Determined by Optical Coherence Tomography. [ Time Frame: baseline, and wk 24 (end of study) ]
  Optical coherence tomography (OCT) is amedical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media (e.g., biological tissue). OCT is based on low-coherence interferometry, typically employing near-infrared light. The use of relatively long wavelength light allows it to penetrate into the scattering medium. OCT is a noninvasive procedure that uses optical interferometry to visualize the structures within the retina. Following dilation of the pupil, a light source operating at 850nm provides probe illumination which is split and detected with and without the refraction of the retinal tissues. Cross-sectional imaging is accomplished in 1.3 second by acquiring a sequence of interferometric A-scans. A false color tomogram of optical reflectivity is produced by the computer. Central foveal thickness will be the primary variable derived from OCT. A increase in thickness could translate to disease progression.
• To Establish the Impact of AIN457 on Quality of Life of Posterior Segment Uveitis Patients Secondary to Behçet's Disease Refractory to Systemic Immunomodulatory Therapy as Measured by National Eye Institute Visual Function Questionaire-25 and Euroqol. [ Time Frame: screening, and wk 24 (end of study) ]
  The VFQ-25 is a reliable and valid 25-item version of the 51-item National Eye Institute Visual Function Questionnaire (NEI-VFQ). It is especially useful in settings such as clinical trials, where interview length is a critical consideration. Scores range from 0 to 100, with higher scores indicating better visual function.
• To Observe the Effect of AIN457 on the Systemic Non-ocular Manifestations of Behçet's Disease in Patients With Posterior Segment Uveitis Requiring Systemic Immunosuppression as Measured by the Bechet's Disease Current Activity Form. [ Time Frame: baseline and wk 24 (end of study) ]
  The BDCAF scores oral and genital ulceration, skin, joint and gastrointestinal involvement, presence of fatigue and headache according to the duration of symptoms. The presence and type of large-vessel and central nervous system (CNS) involvement are documented. Eye activity was deemed present if there was a history of blurring of vision or if the eye was painful or red. . The BDCAF score was calculated by adding the score of each index and ranged between 0 and 12 A reduction in score signifies a lessening of the disease.

Original Secondary Outcome:

• To determine if AIN457 can reduce the need for standard-of-care immunosuppressive medications (ISM) in patients requiring systemic immunosuppression to treat/prevent posterior segment uveitis secondary to Behçet's disease as measured by the ISM score. [ Time Frame: 24 weeks ]
• To assess the safety of targeted IL-17 inhibition with AIN457 in patients with posterior segment uveitis secondary to Behçet's disease receiving standard-of-care immunomodulatory therapy as measured by applanation tonometry and adverse events. [ Time Frame: 24 weeks ]
• To Determine the Effect of AIN457 on Macular Edema and Visual Acuity in Patients With Posterior Segment Uveitis Secondary to Behçet's Disease as Determined by Optical Coherence Tomography. [ Time Frame: screening, baseline, and wk 24 (end of study) ]
• To Establish the Impact of AIN457 on Quality of Life of Posterior Segment Uveitis Patients Secondary to Behçet's Disease Refractory to Systemic Immunomodulatory Therapy as Measured by National Eye Institute Visual Function Questionaire-25 and Euroqol. [ Time Frame: screening, and wk 24 (end of study) ]
• To Observe the Effect of AIN457 on the Systemic Non-ocular Manifestations of Behçet's Disease in Patients With Posterior Segment Uveitis Requiring Systemic Immunosuppression as Measured by the Bechet's Disease Current Activity Form. [ Time Frame: baseline and wk 24 (end of study) ]

Dates:
Date Received: October 13, 2009
Date Started: October 2009
Date Completion:
Last Updated: August 13, 2015
Last Verified: August 2015